New ECHO closing gaps in trans and gender diverse care

For Nurse Practitioner Kristen Patrick, Kenora doesn’t feel quite as isolated as it did a few weeks ago, thanks to CAMH’s new ECHO Ontario Trans and Gender Diverse Healthcare.

Using video conferencing, Kristen is learning from experts in Toronto as well as 30 other primary care providers at 16 sites across Ontario as she builds a better understanding of how to deliver trans and gender diverse health care.

“I live and work in a community that is fairly remote, hours from Winnipeg, but I still need to be relevant in terms of providing sensitive, compassionate appropriate care to the people that pass through our doors,” explains Kristen, a member of the Sunset Country Family Health Team in Kenora. “ECHO offers such a great opportunity to share knowledge and let that excellence of care trickle into places that normally wouldn’t have those resources.”

Using video conferencing and a collaborative hub-and-spoke model, ECHO connects experts in Toronto — the hub — with primary care providers in remote areas across the province to discuss complex issues around trans and gender diverse health care, including assessment and referral to OHIP-funded transition-related surgeries. Launched May 2 by CAMH’s Adult Gender Clinic, the ECHO’s eight sessions are aimed at improving knowledge and skills while reducing disparities in the overall quality of care for rural and underserved areas.

“What a great way to share knowledge with other parts of Ontario, where people are sometimes struggling to figure out what to do,” says Dr. Chris McIntosh, Clinic Head. “People in these communities are just trying to manage the best they can to understand what their patients are going through and how to help them. Through ECHO, we have a whole hub of experts available on various aspects of transgender care.”

It truly is a collaborative approach to education. Anonymized patient scenarios are brought forward by either the hub participants in Toronto or the spoke sites across the province, and all participants offer their insight as to how best to approach issues.

“We have the hub with the experts in the middle, but we’re careful that when we ask for recommendations that we don’t go to them first; first, we go to the spokes,” says Dr. McIntosh. “There are a lot of people in remote communities that do know a lot. We’re not dealing with a black hole of knowledge around this.”

As for Kristen, the ECHO has already broadened both her knowledge and network, having provided an opportunity to connect with fellow nurse practitioners in Toronto and elsewhere.

“Many people don’t necessarily feel that gender-- or how people identify themselves – is relevant to providing care, but I really like clients to know I’m genuinely interested in who they are,” Kristen says. “That increases the chances of them accessing care when they need it, and that’s safer on the whole for everyone.”

This ECHO is part of the larger Project ECHO Ontario Mental Health at CAMH and the U of T, which also runs ECHOs in First Nations, Inuit and Métis; Addiction Medicine and Psychosocial Interventions; Obsessive Compulsive Disorder; as well as general Mental Health issues.

ECHO Ontario Trans and Gender Diverse Healthcare is a collaboration between CAMH, Sherbourne Health Centre, Sick Kids and the U of T.